Method, arrangement and program for a prosthetic installation

ABSTRACT

In a method and arrangement for allocating prosthetic installation work between at least three parties (A, B, C) a dental situation and fixture application are simulated on a computer screen by the first party. The second party produces first components in connection with the prosthetic installation with the aid of a recording and said simulation. Second components are supplied by the third party (C) and the prosthetic installation is assembled and fitted by the first party by means of said first and second components. The recording includes first and second readings of a loose prosthesis and a portion supporting the prosthetic insallation. The simulation includes collation of representations of the readings on a computer screen. Simulated fixture applications are constructed and a model is produced by one of said parties, or a fourth party. An assembly template guides hole-forming members in an actual substrate in directions which correspond to the directions of the fixtures. A dental bridge is provided with attachment holes which connect to the holes formed in the substrate. Fixtures are applied in said formed holes by the first party and the dental bridge is secured in or on said fixtures. The invention also relates to a computer program in connection with the above.

This application is a reissue of U.S. Pat. No. 7,175,435, which is isthe U.S. National Phase under 35 U.S.C. §371 of InternationalApplication No. PCT/SE01/02898, filed Dec. 27, 2001, which claimspriority under 35 U.S.C. §119 to Swedish Patent Application No. SE0004884, filed Dec. 29, 2000.

The present invention relates to a method for allocating prostheticinstallation work between at least three parties, where a dentalsituation and fixture applications therein are simulated on a computerscreen (in computer equipment) by the first party, first components inconnection with the prosthetic installation are produced by the secondparty with the aid of a recording and said simulation, second componentsare supplied by the third party, and the prosthetic installation isassembled and fitted by the first party by means of said first andsecond components. The invention also relates to an arrangementconnected with this method.

The invention also concerns a method for replacing, in a shortapplication time, a loose prosthesis with a fixed installation in acompletely or partially edentulous patient. A short application time isunderstood, for example, to be a time of 1 to 4 hours, for example ca.1½ to 2 hours. The arrangement is intended for applying fixedinstallations, for example in the form of dental bridges, in patientswho are completely or partially edentulous, at least in one jaw bone,preferably the upper jaw bone. The arrangement can comprise first units(or items of equipment) with the task of determining measures in thevarious patient cases, dealing with the production of computerizedrepresentations with fitted fixture applications in the various cases,producing working models of the desired installations and opposite jawbone, ordering the production of dental bridges and fixtures andsecuring members for securing the dental bridges, and effecting theapplication of the fixtures and the securing of the installations ordental bridges in the patients' jaw bones. Said first units or items ofequipment are related to dentists, dental specialists, prosthetists,surgeons, clinics or hospitals for X-ray tomography, etc. Second unitsor items of equipment which represent or are located at dentaltechnicians or the like use information relating to the computerizedrepresentations and the working models to produce templates for formingfixture holes on the patients and the patients' dental bridges. A thirdunit or item of equipment which represents a supplier of basic elementsand/or structural parts (cf. PROCERA) receives from the first units oritems of equipment, via ordering and distribution channels, the orderfor fixtures and accessories which are necessary for executing thevarious orders for different patients. The ordering and distributionchannels can comprise or consist of telecommunication and/or computerlinks, it being possible for the Internet to form or be part of one ormore links. The arrangement can thus permit, within said short time, theapplication of a prosthetic installation by means of structural parts,dental crowns, dental bridges, etc., received from a second party whocan include said dental technicians, and components, for exampleimplants, spacers, securing screws, etc., received from a third party,who can be a producer of basic elements and structural parts. Thestructural parts can be extracted with production parts which canconsist of models, templates, impressions, readings, tools, etc., andequipment or items of equipment for complete or partial production ofthe production parts, which equipment or items of equipment are owned byor available to at least the third party, which signifies that in analternative embodiment the third party is able in turn to arrange theproduction to be done by a further party specialized in the particularproduction part or production parts. The arrangement can thus permit,with considerable precision requirements, the securing of a particulardental installation in a jaw bone or other bone of a patient by means offixtures and securing members. The arrangement can in this case compriseor operate with first equipment for imaging the jaw bone and possibleprosthesis, second equipment for reproducing representations of the jawbone and possible prosthesis in computer equipment, said computerequipment being intended to permit virtual or planned fixtureapplication in the representation. The arrangement also comprises oroperates with third equipment for producing an installation part basedon the representation, and fourth equipment for producing workingmodels, by means of which attachments can be made on the installationpart and the latter can be finished. The invention also relates to anarrangement which permits a responding party to supply to an inquiringparty or parties information which may concern the prostheticinstallation and the work associated with the latter. A computer is inthis case designed to simulate a dental situation and fixtureapplications therein. One or more production units are arranged toproduce components intended for the prosthetic installation and forfitting the latter, and equipment located at the respective inquiringparty is designed to permit or prepare the prosthetic installation. Inaddition, the arrangement is intended to permit the supply of componentsor products for prosthetic installations and the design of these fromthe producing party to the party ordering the components. The supply isin this case based on the handling of orders, finances, invoices, thecomponents or the products and the ordering parties, i.e. the customers.The invention also proposes a program stored on a computer medium forgenerating a protocol with the aid of one or more computers forproduction, fitting and/or monitoring of the production and fitting ofdental prosthetic installations. One party or unit in this case suppliescomponents or products for the prosthetic installations and the designsof these. The parties or units ordering said components or productsprepare and install the prosthetic installations.

In connection with installations of this type, it is already known touse X-ray tomography and other imaging principles in order to exactlydetermine the respective dental situation of the patient. It is known touse computer equipment located with a dentist, prosthetist, dentalexperts, etc. and to input into the computer equipment representationsfrom the radiography and impression results and to virtually adapt andapply fixtures in connection with said representations. Readingapparatus, for example for reading off a loose prosthesis or the like,are known per se. The apparatus can work according to differentprinciples, for example laser scanning principles, photo principles,etc. It is also already known to use production functions for a dentalor other body-related model with the aid of stereolithography.

Reference is made in purely general terms to “Computer Technology”,published by Jos Vander Sloten ???? 2000. Reference is made inparticular to the section “An image-guided planning system forendosseous oral implants” by Kris Verstreken et al., pages 192-240.

Reference is also made in purely general terms to Handboek OraleImplantaten 1999, Bohn, Stafleu.

Reference is also made to various lecture programmes and coursesarranged by ??? prior to May 2000.

Reference is also made to the PROCERA SE production system whichconcerns computerized and automated production of basic elements,models, tooth replacements (e.g. sleeves, dental crowns, etc.).Reference is made in this connection to the patents and patentapplications WO 98/44865 and ???? owned by Nobel Biocare AB, Sweden.Reference is also made to Swedish Patent SE 457,691 with the same ownerand relating to the production of dental products by means of carbonfiber-reinforced plastic. Reference is also made to the Swedishapplications filed by the same Applicant as the present application,namely “Device for determining position”, “Method and device for adental unit or unit intended for the human body”, and “Device forforming holes and inserting sleeves in a unit included in a dentalattachment part”.

Reference is also made to the range of products commercially availablefrom Nobel Biocare AB, Sweden, namely sleeves, dental bridges, fixtures,securing members, tools, apparatus, instruments, etc.

It is already known to design a fixed installation for a patient who iscompletely or partially edentulous and wishes to have an installationfitted, for example instead of an already existing prosthesis. Theinstallation work in question has been extremely time-consuming and hasinvolved a number of trials on the patient covering a long period oftime which has extended over weeks and months. The patient has foundsuch treatments inconvenient and for this reason has been unwilling toaccept or has completely refused to undergo the treatment in question.There is now a general need to reduce the actual treatment time for thepatient. The present invention deals with this problem and proposes thatthe actual insertion or implantation of the fixed installation must beable to be carried out in an extremely short time, for example in oneday or part of a day.

The present invention is based on the recognition that the precisefitting work which was previously carried out on the patient can beundertaken outside the patient by means of the exactness or precisionbeing built into, on the one hand, the equipment used by the partiesinvolved (the units, equipment) for the different parts of theinstallation, and on the other hand into the production of models withthe aid of apparatus/tools, and also into the basic elements for thestructural parts, and the structural parts themselves. The inventionsolves this problem too.

In connection with the production of the installations and the fittingof the installations, there are considerable cost restraints on theparties who are concerned with the production and the installation ofthe tooth replacements in question (e.g. dental crowns). A problem whichthe invention solves in this connection is that of providing a way ofallocating the finances provided for in each individual case between thedifferent parties. It is important that the allocation of work and theroutines surrounding the handling between the parties are so efficientthat the economic target can be fulfilled despite the considerableprecision requirements imposed on the installations in question. Theinvention also solves this problem and proposes production principles,work allocation principles and advantageous debiting principles for saidinstallations. Among other things, the third party (who in some of thesubsequent arrangements of the parties has also been referred to as thesecond party in the chain, and this for technical reasons) must be ableto ensure efficient and accurate distribution and debiting of the basicelements, parts and services involved. The second party (who fortechnical reasons can also be referred to as the third party in certaincooperation formats) must be able to perform his part of the work andsatisfy the precision requirements which have been set. The first partymust, as previously, be responsible for diagnostics and produce imagesand models of the patient and carry out the final installation work in avery short time. The debiting and mutual allocation of the resourcesprovided must in this case be able to be done in accordance with what isproposed by the invention.

It is important that apparatus and methods and elements which are knownper se and well proven can be used for the production of theinstallations and fitting of the installations in question. Theinvention also solves this problem and is based on known techniques andknown methods being able to be used as far as possible.

It is known that a large number of dental crowns and dental bridges, forexample ceramic crowns or dental bridges (AC crowns; AllcerAM) have beenproduced and fitted during the last ten years. These have been producedby, among others, Nobel Biocare, Gothenburg, Sweden. The system known asthe PROCERA CAD/CAN system has been used, in which a detailed recordingof, inter alia, preparation surfaces has been stored in digital form ascomplete data files combined with identification of tooth type andorders via the computer network. These data files permit visualizationof each preparation on a computer screen, and the two-dimensionalprofiles thus obtained have been used in earlier studies in order toobtain an overview of the various structures on the preparations. Inthis respect, it has been found that there is a great variation betweendifferent groups of dentists. It is therefore possible to further refinethe recommendations for the installation work and the structures on theinstallations. The invention also solves this problem.

The features which can principally be regarded as characterizing amethod according to the invention are that the recording includes afirst reading of an impression or prosthesis (tooth structure) and asecond reading of a portion (all or part of a jaw) supporting theprosthetic installation, that the simulation includes collation ofimages or representations on the computer screen, which images orrepresentations result from the first and second readings and on thebasis of which the simulated fixture applications are constructed, andthat the simulated fixture applications include chosen positionings inrelation to said supporting portion. The method is further characterizedby the fact that a model, for example made of plastic, is produced,preferably by a stereolithography method, by one of said parties, or afourth party, and that the first components include an assembly templatewhich can be applied to said substrate and is produced by means of themodel and is intended for hole-forming members which are guided by theassembly template in the substrate in directions which correspond to thedirections of the chosen positionings. Finally, the method can beconsidered as being characterized by the fact that the first componentsinclude a unit forming part of the installation, for example a dentalcrown, which is provided with attachment holes which connect to theholes formed in the substrate, that the second components include thefixtures which are applied in said formed holes by the first party, andthat the second components also include securing members, for examplesecuring screws, for securing the unit in said applied fixtures.

Further developments of the method are set out in the attached dependentclaims concerning said method.

The features which characterize an arrangement according to theinvention are, inter alia, that the recording includes a first readingof an impression or prosthesis (tooth structure) and a second reading ofa portion (all or part of a jaw) supporting the prosthetic installation,that the computer (i.e. its program) is intended, in connection with thesimulation, to permit collation of images or representations on thecomputer screen, which images or representations result from the firstand second readings, and to indicate on these the simulated fixtureapplications which include chosen positionings in relation to saidsupporting portion, and that second equipment, preferablystereolithography equipment, which is located with one of the parties,or with a fourth party, is intended for production of a model, forexample of plastic. Further characteristics are that the firstproduction unit is provided for production of an assembly template whichhas been constructed by means of the model and which has guide elementsfor hole-forming members which can be guided by the assembly template inorder to assume directions which correspond to the directions of thechosen positionings, and that the first production unit is also providedfor production of a structural unit or structural part, for example adental crown, which forms part of the installation and which is providedwith attachment holes which connect to the holes formed in thesubstrate. Further characteristics are that the second production orsupply unit produces or supplies the fixtures intended for said formedholes, and also securing members (for example, screws) for securing thestructural unit in the fixtures which are applied in the substrate.Further developments of the novel arrangement are set out in thedependent claims concerning said arrangement.

The invention relates to different method steps, where a first stepincludes control, for example primary radiography, of the jaw-bonestatus by the first party who in this case can be a dentist, dentalspecialist, prosthetist, etc. If the status is acceptable, X-raytomography is performed by a surgeon, hospital, clinic, who or whichhave access to the radiography equipment in question. A simulated firstrepresentation of the X-ray tomography is input into the computerequipment, preferably by the first party. A simulated secondrepresentation of a scanning or reading of a loose prosthesis isadditionally input into said computer equipment, which scanning orreading can be carried out by the first party or second party. The firstand second representations are coordinated in the computer equipment, inconnection with which virtual fixtures are placed in position by thefirst party, who in this case can be a dentist, prosthetist, dentalexpert, etc. The result thus obtained is transferred, preferably via thetelecommunications and/or computer network, which can include theInternet, to a second party who in this case is a producer of dentalbasic elements and structural parts (cf. PROCERA) in the form ofcomputer information or digital information which can be related to thefirst and second representations, said coordination and said virtualfixtures. Thereafter, production of the actual model is carried out onthe basis of the information thus transferred and thus received, andpreferably with the aid of stereolithography, which model can be aplastic model of the first and second representations, this being doneby the second party who owns or has access to stereolithographyequipment. Elements are introduced into the actual model, for exampletubular elements which extend and are placed in positions and directionscorresponding to the positions and directions for the virtual fixtures.The actual model is thereafter transferred to a third party who in thiscase is a dental technician or the dental laboratory. A loose prosthesismodel, preferably made of wax, is also transferred to the third party,preferably from the first party, together with a jaw model of theopposite jaw, which last-mentioned model can be made of plaster. Inaddition, a bite register index is transferred to the third party, i.e.the dental technician. The third party (the dental technician) uses anarticulator in order to produce the patient's bite configuration bymeans of said loose prosthesis and jaw models and bite register index,taking into consideration the soft-tissue space between jaw bone andteeth. The third part (the dental technician) uses the jaw model toproduce an assembly template with a defined position of application toor in relation to the jaw model and thus in relation to the patient'sjaw and with identified directions and positions for fixture dummies andthereby for the planned recesses in the patient's jaw bone. Productionby the third party (dental technician) of a tooth replacement, forexample the dental bridge, by means of the jaw model, and finally theassembly template and the produced tooth replacement or dental bridgeare transferred to the first party (dentist, prosthetist, surgeon, etc.)who, by means of the assembly template, forms holes for the plannedfixture insertions and, after insertion of the fixtures in the holes,anchors the dental bridge to the fixtures thus inserted.

Another characteristic is that the supplier of basic elements andstructural parts (called the third unit in another related case)supplies basic sets of elements, which can consist of fixtures, securingscrews, tools, etc., to the first units which are dentists, dentalspecialists, prosthetists, etc., as a function of first orders. Thebasic sets can in this case cover the different variations which canarise in the particular dental situations which can consist of applyingdental bridges to completely or partially edentulous patients. On thebasis of second orders, the last-mentioned supplier of basic elementsand structural parts (PROCERA) supplies accessory elements belonging tothe basic sets, which accessory elements make it possible to deal withdifferences in the jaw-bone status and jaw-bone sizes of patients. Inother words, as is known per se, the patients have jaw bones ofdifferent sizes and structures and for this reason said accessoryelements to the basic set are required in order to permit effectivetreatment by the dentist, prosthetist or the like.

The producer of basic elements and structural parts (PROCERA) or thethird party owns, or has available to it, equipment designed to operatewith an ordering function in which the equipment receives, via atelecommunications and/or computer link, for example including theInternet in accordance with the above, information relating to a dentalsituation with jaw-bone structure simulated on computer by the firstparty, a model of the installation applied to this, and fixtures(implants) applied in the jaw-bone structure and belonging to theabovementioned components, and in addition the equipment belonging tothe producer of basic elements and structural parts is designed tooperate with stereolithographic production of an actual model, forexample made of plastic, of said simulated jaw-bone structure andsimulated model, which actual model is included in said productionparts.

The components and optional production parts held by the third party(producer of basic elements and structural parts) can in this case bearranged in platforms which are adapted in dimensions to different sizesin different dental situations (i.e. greater or lesser widths, heights,etc., of the jaw bone and installations in question). Thus, treatmentarrays for different situations can be offered. The basic arrays can bepresented in different platform situations, where a first platformrelates to the dimensions “wide”, “regular” and “narrow”, which thusrelate to the jaw-bone structures.

The invention can also relate to an arrangement with different items ofequipment, in which first equipment is designed for imaging the jaw boneand any prosthesis, second equipment for reproducing a representation ofthe jaw bone and the possible prosthesis in the computer equipment, saidcomputer equipment being designed to permit virtual fixture applicationin the representation, third equipment for producing an installationpart based on the representation, and fourth equipment for producingworking models by means of which attachments can be effected on theinstallation part and the latter can be finished. The arrangement inquestion, preferably the fourth equipment, is designed to producehole-forming templates which can be applied with precision to the jawbone, and the items of equipment operate with an accuracy whichsatisfies said considerable precision requirements and eliminates theneed for carrying out sample trials on the patient between the stages ofimaging and hole formation, all this with the aim of achieving a shorttime for securing the installation, which short time can be, forexample, 1 to 3 hours, during which holes are formed and fixturesapplied and the installation is secured in the implanted fixtures.

The invention is also characterized in that between the abovementionedordering and production functions (equipment) there is a storagearrangement for likewise abovementioned handling. The storagearrangement will be of modular design with a substantially identical orcorresponding structure for each module. The modules can be expanded orreduced on the basis of the number of new customers or departingcustomers. Alternatively, the customer clientele may change characterand/or be redistributed.

The invention also relates to the fact that a data-processingarrangement can contain or receive data or information relating toselected parameters of installations previously produced in thepractice. The data-processing arrangement can be designed to receive andcompare one or preferably several parameters of the current prostheticinstallation with a corresponding parameter or corresponding parametersof said selected parameters. Said information can represent the resultof the particular comparison and can, for example, relate to one or moreproperties of the prosthetic installation, for example strength,esthetic appearance and/or color. In addition, the information canconsist of or comprise details and/or data to the effect that theprosthetic installation conceived of by the inquiring party and/or theassociated work on this installation is within a risk zone andunacceptable.

The invention also refers to a program stored on a computer medium forgenerating a protocol with the aid of one or more computers in theproduction, fitting and/or monitoring of the production and fitting ofdental prosthetic installations, where a party or unit suppliescomponents or products for the prosthetic installations and the designof these, and where ordering parties or units who ordered saidcomponents or products prepare and insert the prosthetic installations.The features which can principally be regarded as characterizing theprogram are the stages comprising: definition of patient and his/hertooth and/or jaw-bone status, definition of work procedure for thepatient based on production and comparison with stored data relating tosimilar or corresponding prosthetic installations; definition of theadvantages with the current prosthetic installation; definition ofmodels, for example drill model; definition of X-ray tomography;definition of two-dimensional or three-dimensional CADD equipment;definition of model production by means of stereolithography; definitionof model production by dental technicians; and definition ofpreparations by surgeon. The definitions in question take place inparallel with production of definitions of variables, documents, forms,folders and/or envelopes.

By means of what has been proposed above, the work time on patients issurprisingly shortened. After said short time, the patient can alreadyleave the dentist, prosthetist, surgeon, etc., with a fixed installationapplied in his jaw. The fixed installation can incorporate effectivelywithout too much inconvenience to the patient, who thereby avoids aprotracted process involving insertion of fixtures and tests being doneon these, which tests have hitherto comprised a number of trials. Theprecision requirements can be built-in with the second and thirdparties, i.e. the dental technician or the dental laboratory and thesupplier of the basic elements and structural sets (cf. PROCERA). Thealready known range of basic elements and structural parts can alsocontinue to be used, and the invention affords the dental technician orthe dental laboratory a method and equipment which simplify and shortentheir work, while satisfying the professional requirements. Existingdebiting and distribution channels can be used by the third party(PROCERA) which in this respect has available to it or owns an advanceddebiting and distribution system. Some parts of the method and theequipment operate with dental technology, and the information for X-ray,scanning, imaging etc. can be transmitted digitally in a manner knownper se. The various digital representations of advanced X-ray imaging,advanced models and structural parts (obtained by stereolithography, forexample) can be easily transferred via existing links in thetelecommunications and/or computer network. Computer programs forproducing the models in question with very great precision are availableon the market and can be used in this context. Said exact models can beused as structural models by the dental technician or the dentallaboratory, which receives guarantees of the required precision inconnection with dental installations. The invention also affords refinedtreatment methods in connection with the production of models,templates, etc., and also structural parts and installations which areto be used by the dental technician, prosthetist, dental expert,surgeon, etc. In accordance with the invention, algorithms can bedeveloped for calculation and computer. programming in order to collateand handle different data parameters for example characterized by formand installations of a large number of preparations. Thus, it ispossible to calculate a certain number of characteristic parametersconcerning the shape of the preparation, compare these with visualcharacteristics for the preparations, establish the most frequentdifferences from an ideal, and study possible geographically relatedvariations. It is possible to propose corrections in the event ofcritical differences from ideal preparations and also to indicatefailures which occur upon insertion of the installation or some timeafter the use of the installation by the patient. A computer program cancalculate variations of critical parameters in each installation, whichcan mean that the useful life of future installations may be extended.

A presently proposed embodiment of an arrangement and method will bedescribed below with reference to the attached drawings, in which:

FIG. 1 is a basic circuit and block diagram showing the patient andthree parties involved in supplying a fixed installation for thepatient's jaw bone, and the flow of components, structural parts andbasic elements between the parties, and also the debiting functionsconnected with the above,

FIG. 2 is a basic circuit and block diagram showing the distribution anddebiting paths for the parties involved,

FIG. 3 is a basic circuit and block diagram showing how a large numberof patients can turn to a large number of first parties who in turn areserved by a smaller number of dental technicians or dental laboratorieswho in turn are served by a third party (PROCERA),

FIG. 4 is a basic circuit and block diagram showing how the parties A, Band C are interconnected with their computer equipment via differenttypes of links,

FIG. 5 is a vertical section and partial cutaway view showing theproduction of a hole-forming template (assembly template) using a modelwhich images the jaw bone, and a fixture dummy and expansion spacer andexpansion screw applied in the model,

FIG. 6 is a vertical view and partial cutaway view showing parts of thedental installation applied on or in a jaw bone,

FIG. 7 is a basic circuit diagram showing the cooperation between theparties or the units A, B and C,

FIG. 8 is a perspective and symbolic view showing the commercialhandling of installations and customers associated with theinstallations,

FIG. 9 is a perspective view showing a module system for handlingaccording to FIG. 8, and

FIG. 10 shows a flow chart for a dental installation on a patient.

In FIG. 1, a patient is symbolized by P and three parties by A, B and C,a first party being a dentist, prosthetist, dental expert, surgeon,etc., i.e. the party or subsidiary party dealing with the diagnosis andactual installation work on the respective patient. A second party B isrepresented by the dental technician or the dental laboratory, and athird party C is a supplier of basic elements and structural parts (cf.PROCERA). In the present case, the third party has access to automatedproduction of the basic elements and structural parts in question. Theequipment or units located with the first party are symbolized by 1, theequipment and units located with the second party are symbolized by 2,and the. equipment and units located with the third party are symbolizedby 3. At the first party A, the distribution between the variousfunctions, for example a dentistry function, prosthetic function, dentalexpert function, surgical function, etc., is utilized in a manner knownper se by the patient P. The party A can be considered as having accessto X-ray functions at a hospital, clinic or corresponding establishment4. In the present case, the third party C can own or have access (forexample on a contract) to stereolithography equipment 5 of a type knownper se. The first party A (i.e. the actual subsidiary party) firstundertakes a preliminary examination of a patient P in order to assesswhether he or she is in fact suitable or not for a fixed installation ina given jaw bone. In the first instance, the patients are completely orpartially edentulous in the upper jaw, for which reason an examinationof this jaw is most often carried out. It is possible per se to providefixed installations in a lower jaw which is missing one or more teeth.In a case where it is decided that the patient is able to receive afixed installation, the patient's jaw or jaw part must be read off orscanned. In addition, imaging of any loose prosthesis (tooth prosthesis)must be carried out. In the present case, the imaging function isindicated in FIG. 1 by means of arrows 6 and 7, where the first arrowrepresents the imaging of the jaw or jaw part, and the arrow 7represents the imaging of any loose prosthesis. In cases where there isno loose prosthesis, a model is produced which could be considered tocorrespond to the loose prosthesis in question. In a case where theparty A uses X-ray tomography, the patient is sent to a radiographydepartment at a hospital 4 or the like if the first party A does nothave such X-ray equipment. This contact between the patient and theradiography department is symbolized by 8 in FIG. 1. In a case where theradiography department at a hospital 4 or the like is used, the resultof the X-ray examination can be digitalized and sent via a link 9 indigital form 10. Both the hospital 4 or the like and the equipment orunit 1 at the first party A are in this case provided with computerequipment 4a and 1a, respectively. The transfer can be done bytelecommunication and/or computer links in a manner known per se.

In the case where a plastic model or a model made of other material isto be produced by means of stereolithography, the party A contacts ororders from the party C. A digital signal 11 is transmitted by the partyA to the party C who imports or receives the signal 11 in computerequipment 3a. The transmission is made via a link 12 in the direction ofthe arrow 13. The digital signal 11 represents representations of thepatient's jaw bone and loose prosthesis or equivalent. The signal 11also represents a coordination of the imaged jaw bone and the imagedloose prosthesis and also fixture applications which have been made bythe party A in a manner known per se. The link 12 can be made viatelecommunication and/or computer links, which can include the Internet.Here, the expression telecommunication and/or computer links can betaken to mean the generally available links or special links. The partyC contacts a fourth party (not shown in FIG. 1) if the third party Cdoes not itself have the stereolithography equipment in question. Thefourth party in this case owns the equipment in question, and the thirdparty transfers information 12 concerning the order and informationwhich corresponds to the readings taken by the first party A. Theinformation 14 is digitalized and transmitted via telecommunicationand/or computer links in accordance with the above. The direction of thesignal is indicated in FIG. 1 by the arrow 15. The fourth party designsor produces the stereolithographic wax model and sends the latter backto the third party see the arrow 16. Debiting functions and orderingfunctions take place via said link 17, and the debiting functions knownper se are in this case used at or by the party C. The computerequipment located with the fourth party is indicated by 5a. Informationregarding the plastic model produced is sent back if appropriate to thefirst party A in the direction of the arrow 18. The stereolithographicactual model is transferred from the party C to the party B, see arrow19. The second party receives, from the first party, orders to theeffect that the model in question is to be produced. This ordering canbe done via the telecommunication and/or computer network and has beensymbolized in FIG. 1 by the digital signal 20. In addition, information21 concerning planned treatment, individual characteristics, date, cost,etc. is transmitted to the second party B which has access to computerequipment 2a. The first party A also orders from the third party C basicarrays for the given patient type and possible auxiliary arrays whichare intended to meet special characteristics of the patient. Said arrayscomprise different types of basic elements, for example drills/fixtures,drill guides, guide drills and other types of drills, recessing members,fixtures, mounting spacers, screw tighteners, supports, support pins,devices, toothbrushes, cement sets, millers and machines for bitegrinding and means for blocking holes, etc. The ordering and debitingfunctions are effected in the third party's known ordering and debitingequipment. The ordering function is digitalized and is represented by 22in FIG. 1. The distribution path can also be considered as part of thelink 12 in the direction of the arrow 18. Corresponding ordering,distribution and debiting channels are established between the secondparty B and the third party C. The ordering from the second party isdigitalized, in the same way as above, and takes place with digitalsignals 23 in the direction of the arrow 24. Supplies and debitingfunctions from the party C to the party B take place via the link 25 inthe direction of the arrow 19 by means of digital information 26 and ahardware distribution channel which can be considered as forming partof, or is symbolized by, the link 25.

The second party produces, as final products, first components which aresupplied to the first party via distribution channel 27, indicatedsymbolically in FIG. 1, in the direction of the arrow 28. Said firstcomponents comprise an assembly template 29 which the first party usesas a hole-forming member. Also included is a unit forming theinstallation, for example a dental crown 30. The third party suppliessecond components 31 in accordance with the description given above andbelow.

The first party uses the assembly template for forming holes in thepatient's jaw and applies the fixtures which have been obtained from thethird party and are included in said second components 31. In addition,the third party supplies, inter alia, the abovementioned securing screwsto the first party. The first party can form holes, apply the fixturesand anchor the installation or the dental crown to them in theabovementioned very short time. In subsidiary equipment 32 located withthe first party B, use is made, inter alia, of an articulator of a typeknown per se. A model, for example a plaster model 33, of the oppositejaw is applied in the articulator, together with the actual modelproduced by stereolithography, fixture dummies and said bite registerindex. In this connection, soft plastic or the like is used to produce amodel of the gum which will lie between the jaw-bone model and the looseprosthesis model, which is also produced by the first party. The secondparty produces the dental bridge with the aid of the stereolithographicplastic model, to which spacers are mounted on fixtures of the model andcementing sleeves are secured on the spacer. The frame of the dentalbridge is preferably made of carbon fiber-reinforced plastic, but canalso be made of titanium or a dental alloy. The soft-tissue replacementcan be made of vinyl or polysiloxane. The lengths of the spacers and theconfiguration of the bridge with respect to soft tissues are determinedand imaged. Prosthetic teeth are applied on the structural part orbridge skeleton thus formed. The tooth replacement or prosthetic teethare worked for example from a wax model in which the prosthetic teethare made of acrylate and have been tested on the patient. The softtissue can be provided with small pin-shaped or spike-shaped elementswhich are automatically imaged in a computer program during thestereolithographic production. Said assembly template can comprisespacers which bear hole-forming sleeves or drill sleeves and are heldtogether with the aid of said carbon fiber-reinforced plastic.

In FIG. 2, a number of patients are indicated by P, P′, P″, P′″. Thesepatients are assumed to turn to party A who carries out theabovementioned examination and modeling. The patients are handled bymeans of first equipment 34 and the first party, in accordance with theabove, orders the basic sets 35, 36 and 37 and any relevant auxiliarysets 38, 39 and 40 in order to meet the type of dental treatment withits associated variations. The connections of the patients to the firstparty are indicated by 41, 42, 43 and 44. The distribution channels fromthe third unit or party C to the first unit or party A are indicated by45, 46, 47, 48, 49 and 50. Other components, for example structuralparts, tools, instruments, can also be ordered by party A from party Cand are symbolized by component content 51 and the distribution path 52.Thus, for example, the wax model or a representation of the wax modelcan be distributed on this path. The party B can also place orders withthe party C. Such orders can include models, tools, instruments, etc.,and are symbolized by the component content 53 and the distributionpaths 54 and 55, which for example can be parcel delivery routes. InFIG. 2, debiting functions or debiting equipment are indicated by 56 atthe third party, by 57 at the second party and by 58 at the first party.Said debiting channels are established using coupled-up or fixedtelecommunication and/or computer links, which also serve as theabovementioned ordering and data signal transfer channels. Thus, theparty A can order equipment or a model from party C via the link 59,which is recorded by the party C and debited via the same orcorresponding link. The ordering direction is indicated by 60 and thedebiting direction and confirmation direction is indicated by 61. Theparty B can also place orders with the party C, and this is done via alink 62 in a direction indicated by 63. Debiting of the equipment orservice in question can take place via a corresponding link 62 in thedirection 64. In a corresponding way, ordering and debiting functionsare exchanged between the units A and B via a link 65. A parcel link orhardware link 66 is also arranged between these units A and B in orderto permit transfer of models from party A to party B and finishedinstallations, templates, etc., from party B to party A. In FIG. 2,links 67 for the debiting of the patient by the party A are alsoindicated symbolically. In the embodiment according to FIG. 3, a largenumber of patients P are served by a relatively large number of firstparties (dentists, prosthetists, etc.) . The first parties are served inturn by a number of dental technicians or laboratories which are assumedto be present in a smaller number than the number of first parties. Athird unit C (PROCERA) can serve the whole number of patients and firstand second units. In accordance with the above, the third unit suppliessaid basic arrays 68a, 68b, 68c and auxiliary sets 68a′, 68b′ and 68c′belonging to these. Components, instruments, etc., are symbolized by 69and, in accordance with the above, can be supplied to the second partyB, see indicated arrows. The third party can also offer a service, whichhas been indicated by 70, which service can be oriented toward thepatients and said first and second parties. In FIG. 3, the principaldebiting function is indicated by 71. In FIG. 3, the ordering functionsreceived in the different areas are also shown by 72, 73 and 74. Thearrows shown in FIG. 3 indicate the directions of the services,components and debiting in the system.

In FIG. 4, in a block circuit diagram, the computer equipment locatedwith the parties A, B and C is indicated by 75, 76 and 77, respectively.The computer equipment for the X-ray function and for thestereolithography function is indicated by 78 and 79. The computerequipment is connected by modem, see for example 75a and 76a on computerequipment 75 and 76, to different networks. The electronic networks orthe links can consist of the general communications network which inFIG. 4 is symbolized by 80, one or more specially arranged, for examplefixed, links 81 and/or computer network links 82 which can consist of orinclude the Internet. The computer equipment can be connected by therespective modems to one or more of said networks.

For his work, the party B (the dental technician or the dentallaboratory) requires a model which images the jaw bone and the dentalprosthesis with an intermediate space between these, which intermediatespace actually corresponds to the space for soft tissue (gum). Thispermits insertion of the plastic model in an articulator (cf. above) forthe opposite jaw or in a re-mounting block. In the virtual model in thecomputer, the positions for the fixture installations are planned inadvance. Around the holes, or for forming the holes, sleeves made ofsolid material are needed to secure the installation of the fixture inthe plastic model. That part of the plastic model which images the jawbone is seen in FIGS. 5 and 6, where the jaw bone model has beenindicated by 83 in FIG. 5. In FIG. 6, a soft-tissue imitation made ofsoft plastic is indicated by 84. In accordance with the above, theplastic model is obtained from the third party. A model or toothreplacement made of wax with prosthetic teeth made of acrylate is testedout in the patient's mouth and checked for the appropriate color, shapeand articulation. This too is sent to the dental technician who producesthe jaw-bone bridge in order to allow the acrylate teeth of the bridgeto be transferred to the finished dental bridge. In addition, the partyB receives a plaster model or an impression of the opposite jaw made ofimpression material which is not disturbed during transport to thedental technician. The bite register index can expediently be made ofwax in order to permit registering of the jaws' bite relationship toeach other. The insertion of the jaw models in the articulator by thedental laboratory or by the dental. technician must correspond to thebite relationships in the patient's mouth. Conventional prosthesis waxis advantageous in the present case. In addition, the second party willobtain a description of the order, the planned therapy, specialrequirements, for example individual characteristics and other detailswhich concern the work, and the date when the work will be done at theclinic (at the party A).

The first party will in accordance with the above be provided withprosthetic and surgical instruments in accordance with the above. Aplastic model and dental bridge will be available, likewise theabovementioned basic sets and optional auxiliary sets. The plastic modelis according to the above a model of the patient's jaw which has beenimaged with the aid of computerized X-ray tomography. In order to permitbite registering and mounting in the articulator, it also includes thetooth replacement. With the aid of the computer, the positions of theseats for the fixtures are determined in advance in accordance with theabove, and the plastic model is then produced with the aid ofstereolithography using an epoxy material in the present illustrativeembodiment. The model images the jaw bone 83 and the dental prosthesis85 (see FIG. 6) with said intermediate spaces 86 for soft tissue. Thedental prosthesis model is supported on the jaw-bone model 83 with theaid of pins (not shown) which are automatically imaged in the programupon production in the stereolithography process. Suitable fixtures 87are placed in the planned holes/seats on the model. An assembly template88 (see FIG. 5) is produced with the aid of the model. The assemblytemplate represents a template for drill/fixture RP. In the productionof the model, the holes are strengthened with sleeves 89, and thearrangement is also such that an expansion spacer 90 and an expansionscrew 91 are included in order to hold the template in a defined idealposition, even during the actual tightening when the template is notallowed to tilt in its attachments. The spacer 90 bears against thefixture 87. By means of the template production process, said templatecan then be transferred to the patient and there functions as ahole-forming template which provides a high degree of precision. Duringproduction of the template, the latter is provided with support parts88a which bear against the top surface 83a of the jaw model 83. Theextent of the template in or along the entire extension of the jaw bone,with its irregularities, means that the template acquires a preciseposition in the patient's mouth. In a preferred embodiment, the templatecomprises carbon fiber-reinforced plastic.

In accordance with FIG. 3, a dental bridge is produced from the plasticmodel part according to FIG. 6. Special spacers 92 which are intended tobe used by the dental laboratory or by the dental technician are mountedon the fixtures 87 of the model and cementing sleeves 93 are applied onthe spacers. The bridge skeleton 85 can consist of carbonfiber-reinforced plastic, titanium or some other dental alloy. Thespacers are preferably made of titanium and in one embodiment havelengths of 3.5 and 5 mm. The spacers are intended to be cemented on thetitanium sleeves 93 in the bridge in the patient's mouth and screwedtight to the fixtures using gold spacer screws 94. Tooth dummies 95 areapplied on the bridge skeleton in a manner known per se.

The surgeon or equivalent exposes the maxilla at the mucolabial fold(and not at the top of the maxilla as in this case it becomes impossibleto sew flaps together when the dental bridge is put in place). When themaxilla is exposed, an assembly template is applied (in a manner knownper se) for drill/fixture on the dental crest with the aid of thesupport built on both sides of the assembly template for drill/fixture.The correct position must be found in the individual geography of thedental crest. When the assembly template for drill/fixture RP is sittingin a stable position, the work on installing fixtures can be started.The assembly template for drill/fixture is held in place in the correctposition on the dental crest. A drill guide is placed in the actualsleeve on the assembly template. It is advantageous to choose a sleevewhich is placed at the center over one half of the dental arch. Anothersleeve is then chosen which is situated at the center of the other halfof the arch. The hole-forming work can then be started. When the holeshave been formed, the actual fixture is applied until contact is reachedbetween the recessed part in the bone and the fixture. Thereafter, theassembly template is anchored in the applied fixture with the aid of theexpansion spacer, after which the work on applying the fixture on theother side can proceed. When this fixture too is anchored, the assemblytemplate is also secured to this fixture, and when the assembly templatehas been screwed on the first two fixtures installed, it is thenpossible to continue with installing the remaining fixtures, with thedifference that the assembly template sits more securely in place. Whenall the fixtures are installed, the assembly template is unscrewed,after which the dental bridge can be applied on the fixtures which havethus been applied. The dental bridge is tested and, if necessary,adjusted with slight corrections. If, for example, one of the sleeves inthe bridge does not sit exactly on the fixture, it can be adjusted forexample with a round drill. Thereafter, the dental bridge is cemented,which can be done with acrylate-based cement. After the cement hashardened, the bridge can be loosened and temporarily removed. When theflap is sewn back with the fixtures underneath, the bridge is againapplied on the fixtures through the soft tissue. Any bite grinding onthe opposite jaw can be done, and the screw holes are filled again inthe usual way.

According to the above, the dental bridge is produced on the plasticmodel which has been provided with fixture dummies (cf. FIGS. 5 and 6).The gum in the intermediate space between the plastic model and thetooth prosthesis model is produced in advance. Suitable holes arepunched in the gum replacement over the fixtures, in which spacers ofsuitable length are mounted. The sleeves 93 are conical in thisillustrative embodiment. The bridge skeleton 85 is made of carbonfiber-reinforced plastic, cf. said Swedish Patent 457,691. Holeperforation and sleeve application in the carbon-fiber bridge aredescribed in more detail in the Swedish patent applications which werementioned at the outset and which were filed on the same day as thepresent application. The finished carbon-fiber bridge with insertedsleeves 93 is provided in the next step with plastic teeth which aresecured with fast-acting adhesive, for example cyanoacrylate, in therespective place in the silicone casting which is mounted on the patientmodel with the aid of rubber bands. Thereafter, a liquid composition(acryl) is applied between the plastic teeth and around the carbon-fiberskeleton in accordance with the known routine. This is polymerized in anacryl polymerization apparatus in water under pressure at a certaintemperature depending on the selected process. After polymerization andcooling in cold water, the bridge is loosened and cleaned andbite-ground in the articulator according to the known routine.

FIG. 7 shows a jaw (upper jaw) indicated by 96. X-ray equipment isindicated by 97. A digital signal 98 or first representation istransmitted on a line or link 99 to the computer equipment located withthe party A. FIG. 7 also shows a loose prosthesis or a model of a toothreplacement indicated by 100. This too is read off, for example bycomputer tomography, laser scanning, photogrammetry, etc., whichtransmits to said computer equipment a digital signal 103 or secondrepresentation on a link 104. A user 105 operates the computer terminal106 in order, by means of a computer program 107 of a known type, tosimulate virtual images 108 and 109 on the computer screen 110 of saidrepresentations 98 and 103, i.e. of the jaw bone and the looseprosthesis or model thereof, respectively. The user coordinates thevirtual images and plans optimal applications of virtual fixtures 111,112 in the actual jaw bone. The coordinated configuration of jaw bone,prosthesis and fixtures is exported digitally to the party C inaccordance with the above. The signal has in this case been indicated by113, while the link has been indicated by 114. The party C deals, inaccordance with the above, with the production of a plastic model whichincludes the jaw bone, the prosthesis (or equivalent) and replacements(tube elements) for the fixtures or the fixture positions. The model issent as a parcel which has been symbolized by the link 115.

According to the above, the party A also provides the party B with amodel or impression 116 of the patient's lower jaw which has beensymbolized by 117. According to the above, the party B produces anassembly template 118 for the party A, which template is used forguiding hole-forming members (drill) 119. Preliminary drilling 120 hasin this case been carried out with a small drill. FIG. 7 also shows thata fixture 121 has been installed in the jaw bone 96. An articulator 122is shown symbolically by 122, in which the plastic model 123 which wasobtained from the party C has been placed together with the impression116′ which was received from the party A. The abovementioned space 124for the soft tissue or gum is simulated in the articulator. The transferlink for the impression (of plaster) has been shown by 125.

In accordance with the invention and FIGS. 8 and 9, a file system isused for handling customers, orders, production, etc. This file-handlingis intended to be done in a computer arrangement, but in order toclearly illustrate the functions outside the computer world, these havebeen indicated by symbolic hardware. The system is made up of modules,where one module 126 has been. indicated with a file holder 127 whichcan be withdrawn from and inserted into a filing cabinet 128. The fileholder contains a number of files or sections, where a first file hasbeen indicated as an order file 129, a second file as a finance file130, a third file as an invoice file 131, a fourth file as a product orcomponent file 132, and a fifth file as a customer file 133. The contentof the file holder 127 can relate to a certain number of customers, andthe module system as a whole is designed so that incoming customers canbe received by expanding the number of file holders or modules 127. Thedifferent file holders have substantially identical or correspondingcontents, and in FIG. 8 an inserted file holder has been indicated by134.

In FIG. 9, the structure of the module system has been indicated bythree cabinets 126′, 126″ and 126′″. The first cabinet 126′ containsfile holders 127′, 134′ etc. in accordance with the above. The cabinets126″ and 126′″ have substantially the same or corresponding structure.The contents of the different cabinets can be coordinated, which hasbeen symbolized by the link 135, which is also indicated symbolically.In accordance with FIG. 9, the flow of incoming orders and theproduction of products can be separated. In FIG. 9, an order station,which can be the producer itself or the customer directly, is indicatedby 136. In the present case, an order document is shown (i.e. an orderfile) by 137. The document is transferred in the direction of the arrow138 to the storage system which is indicated by 139 and which isarranged between the order sender and the production function. Thetransfer 138 takes place digitally, in accordance with the above, via anelectronic link or wireless communication in a manner known per se. Theproduction function is indicated by 140, and the production function canextract or import a document (or a file) 16 to or from. the storagefunction 139. The transfer direction for the document 141 is indicatedby 142. This connection too can be wired or wireless in accordance withthe above.

In accordance with the invention, as is shown in FIG. 10, a flow chartcan be set up for treating an edentulous patient with a dental plate.The patient is defined with respect to certain parameters, for examplejaw-bone status, age, etc. This definition takes place in the block 143.Thereafter, the patient's status is defined in relation to earlierexperience in the block 144. This comparison function can be performedby the surgeon or prosthetist. Advantages of the desired dentalsituation are defined in the block 145. This definition takes place onconsultation between patient and surgeon.. A model production, forexample production of a drill model, is defined in block 146. The X-raysituation is defined in the block 147, for example whether X-raytomography will be used, whether this will be done at hospital or bycomputer tomography. The production function using preferablythree-dimensional CADD equipment is defined in block 148. Ifstereolithography equipment is to be used for producing the model, thisis done in block 149. A plastic model with fixture markings is definedin a block 150. Thereafter, the dental technician's work is defined inblock 151. Preparations for surgery are defined in block 152. The otherparameters used for data programming are implemented, see above.

The invention is not limited to the embodiment described above by way ofexample, and instead it can be modified within the scope of the attachedpatent claims and the inventive concept.

1. A method for allocating prosthetic installation work between at leastthree parties, comprising: wheresimulating a dental situation andfixture applications therein are simulated on a computer screen by the afirst party,; producing first components in connection with theprosthetic installation are produced by the a second party with the aidof a recording and said simulation, supplying second components aresupplied by the a third party, and assembling and fitting the prostheticinstallation is assembled and fitted by the first party by means ofusing said first and second components, characterized in thatwherein therecording includes a first reading of an impression or prosthesis and asecond reading of a portion supporting the prosthetic installation, inthat the simulation includes collation of images or representations onthe computer screen, which images or representations result from thefirst and second readings and on the basis of which the simulatedfixture applications are constructed, in thatwherein the simulatedfixture applications include chosen positionings in relation to saidsupporting portion, in thatwherein a model, e.g. of plastic, isproduced, preferably by a stereolithopaphy method, by one of saidparties, or a fourth party, in that wherein the first components includean assembly template which can be applied to said a substrate and isproduced by means of based on the model and is intended for hole-formingmembers which are guided by the assembly template in the substrate indirections which correspond to the directions of the chosenpositionings, in that wherein the first components include a unitforming part of the installation, e.g. a dental bridge, which isprovided with attachment holes which connect to the holes formed in thesubstrate, in that wherein the second components include the fixtureswhich are applied in said formed holes by the first party, and in thatwherein the second components also include securing members for securingthe unit in said applied fixtures after application of said fixtures insaid formed holes.
 2. The method as claimed in patent claim 1,characterized in that wherein the model is constructed, preferably bythe third party, in two parts, where the first part represents thesupporting portion (jaw bone) and is generated based on the secondreading and the second part represents the tooth prosthesis/toothstructure a tooth prosthesis or tooth structure and is generated basedon the first reading, the two parts being separated from each other byan intermediate space to permit application in an articulator.
 3. Themethod as claimed in patent claim 1, characterized in that wherein thefirst party sends order descriptions by means of using completely orpartially automated equipment to the second party who receives the ordervia completely or partially automated receiving equipment.
 4. The methodas claimed in claim 1, characterized in that wherein the dental bridgeunit forming part of the installation is produced on the plastic model,and in that wherein spacers are mounted on the fixtures of the model andcementing sleeves are placed on the spacers, and in that the wherein aframe of the dental bridge is preferably made of unit forming part ofthe installation comprises carbon fiber-reinforced plastic, titanium ora dental alloy.
 5. The method as claimed in claim 1, characterized inthat wherein a soft-tissue replacement is between the first and secondparts and is made of soft plastic, e.g. vinyl or polysiloxane, and inthat wherein the lengths of the spacers are secured to, and theconfiguration of the bridge unit forming part of the installation isadapted to, the soft-tissue.
 6. An arrangement for allocating prostheticinstallation work between at least three parties, and comprising: acomputer which is located with the a first party and which is intendedto simulate, on its screen, a dental situation and fixture applicationstherein, a first production unit which is located with the a secondparty and which is intended to permit production of first componentsintended for the prosthetic installation with the aid of a recording andsaid simulation, a second production or supply unit which is locatedwith the a third party and which is used to produce second components,and first equipment which is located with the first party and isintended to allow the prosthetic installation to be constructed andfitted on the a patient with the aid of the first and second components,characterized in thatwherein the recording includes a first reading ofan impression or prosthesis and a second reading of a portion supportingthe prosthetic installation, in thatwherein the computer is intended, inconnection with the simulation, to permit collation of images orrepresentations on the computer screen, which images or representationsresult from the first and second readings, and to indicate on these thesimulated fixture applications which include chosen positionings inrelation to said supporting portion, in thatwherein second equipment,preferably a stereolithography appliance, which is located with one ofthe parties, or with a fourth party, is intended for production of amodel, e.g. of plastic, in that the wherein a first production apparatusis provided for production of an assembly template which has beenconstructed by means of based on the model and which has guide elementsfor hole-forming members which can be guided by the assembly template inorder to assume directions which correspond to the directions of thechosen positionings, in that wherein the first production apparatus isalso provided for production of a structural unit, e.g. a dental bridge,which forms part of the installation and which is provided withattachment holes which connect to the holes formed in the substrate, inthat wherein the second production or supply unit produces or suppliesthe fixtures intended for said formed holes, and also securing membersfor securing the structural unit in the fixtures which are applied inthe substrate.
 7. The arrangement ms as claimed in patent claim 6,characterized in that wherein the model, e.g. the plastic model,consists of comprises two parts, where the first part simulates thesupporting portion and is generated based on the second reading and thesecond part simulates the an impression/prosthesis/tooth or prosthesisor tooth structure and is generated based on the first reading, and inthat wherein between the parts there is an intermediate space whichcorresponds to the a site for soft tissue, which intermediate spacepermits fitting/impaction fitting in an articulator of an opposite jaw.8. The arrangement as claimed in patent claim 6, characterized in thatwherein the model comprises a tooth structure that comprises wax withprosthetic teeth made of acrylate and that is tested on the patient. 9.The arrangement as claimed in claim 6, characterized in that wherein thefirst party uses completely or partially automated ordering equipment,which for example includes an order telephone, telecommunicationsnetwork or computer network, configured to send an order to the secondparty concerning one or more of the planned therapy, individualcharacteristics, date, or cost, etc., and in that wherein the secondparty has access to completely or partially automated receivingequipment.
 10. The arrangement as claimed in claim 6, characterized inthat wherein the recording includes information on the relationship ofthe jaw bites to each other, and in that wherein the information to thesecond party includes details of the articulator/articulators, theinformation preferably being able to be transmitted to the second partyby electronic means.
 11. The arrangement as claimed in claim 6,characterized in that wherein the model which can be produced by thefirst party, for example by means of X-ray tomography, can betransmitted to the second party or the third party by completely orpartially electronic means, e.g. via computer and/or telecommunicationsystems (including the Internet), and in that wherein the third party,e.g. with the aid of the first production unit, constructs a real(actual) model which is sent to the first party or the second party. 12.The arrangement as claimed in patent claim 11, characterized in thatwherein the first part is supported on the second part with the aid ofsmall pin-shaped or spike-shaped elements which are automaticallysimulated in a computer program for stereolithography production. 13.The arrangement as claimed in patent claim 11, characterized in thatwherein the model is provided with fixtures placed in holes or seats inthe model, and in that wherein the assembly template is adapted to saidfixtures/holes/seats.
 14. The arrangement as claimed in claim 6,characterized in that wherein the assembly template comprises spacerswhich support hole-forming sleeves or drill sleeves, in that the spacersare held together with the aid of carbon fiber-reinforced plastic, andin that the template is assigned a contact with the second model partwhich corresponds to the patient's jaw bone, the template being able tobe placed in a corresponding position in the patient's mouth.
 15. Thearrangement as claimed in claim 6, characterized in that wherein thedental bridge structural unit comprises spacers which can be mounted onthe fixtures of the model, and in that wherein cementing sleeves arearranged on the spacers, and the frame (skeleton) of the dental bridgeconsists of comprises carbon fiber-reinforced plastic, titanium or someother dental alloy.
 16. The arrangement as claimed in claim 6,characterized in that wherein a soft tissue replacement is in saidintermediate spaces and is made of soft plastic.
 17. The arrangement asclaimed in claim 6, characterized in that wherein the spacers comprisetitanium and are intended to be cemented on the titanium sleeves in thebridge in the patient's mouth and to be screwed to the fixtures withspacer screws made of gold.
 18. The arrangement as claimed in claim 6,characterized in that wherein the second components comprise assemblytemplates for drills/fixtures RP, drill guides, guide drills and othertypes of drills, recessing members, fixtures, assembly spacers, screwtighteners, supports, guide pins, mandrels, toothbrushes, cementcompositions, milling devices and machines for bite grinding andhole-blocking means, which second components are arranged in differentplatforms with different dimensions.
 19. The arrangement as claimed inclaim 6, characterized in that wherein the first apparatus is designedto permit, upon transfer of the first and second components, a shorttime for fitting the installation on the patient of from between 1 to 4hours, preferably 1½to 2 hours.
 20. A method for constructing componentsrelated to a prosthetic installation, comprising: receiving, by computerequipment, data based on a simulated graphical representation of adental structure of a patient, the dental structure comprising at leasta portion of the patient's jawbone; receiving, by the computerequipment, data indicative of one or more desired virtual fixturelocations in the patient's jawbone, the desired virtual fixturelocations placed in position using, at least in part, the simulatedgraphical representation of the dental structure of the patient;receiving an actual physical model created based at least in part usingcomputer information corresponding to the simulated graphicalrepresentation and the data indicative of the desired virtual fixturelocations, the actual physical model comprising physical representationsof the at least a portion of the patient's jawbone and of the desiredvirtual fixture locations; providing an assembly template comprising oneor more guide holes that are oriented based on the desired virtualfixture locations, the assembly template configured to be applied to thepatient and to guide a drilling tool through the guide holes fordrilling one or more holes in the patient's jawbone corresponding to thedesired virtual fixture locations; and constructing a prostheticinstallation at least in part using the actual physical model, theprosthetic installation configured to attach to the jawbone of thepatient via one or more fixtures, wherein the one or more fixtures areconfigured to be inserted in the one or more holes drilled in thepatient's jawbone, wherein the prosthetic installation is configured tobe installed using the assembly template and the one or more fixtures.21. The method of claim 20, wherein the dental structure furthercomprises one or more loose prostheses.
 22. The method of claim 20,wherein the prosthetic installation comprises a dental bridge.
 23. Themethod of claim 20, wherein the prosthetic installation is installedonto the one or more fixtures using one or more securing members. 24.The method of claim 20, wherein the physical representations of thedesired virtual fixture locations comprise one or more holes in theactual physical model.
 25. The method of claim 20, wherein the assemblytemplate comprises one or more sleeves through which the one or moreguide holes extend.
 26. The method of claim 20, further comprising:applying the assembly template to the patient's jawbone; and inserting adrilling tool into the one or more guide holes of the assembly templateto form the one or more holes in the patient's jawbone corresponding tothe desired virtual fixture locations.
 27. The method of claim 20,wherein the assembly template is constructed using the actual physicalmodel.
 28. A method for constructing components related to a prostheticinstallation, comprising: receiving, by computer equipment, dataindicative of one or more desired virtual fixture locations in a dentalstructure of a patient, the desired virtual fixture locations placed inposition using, at least in part, a simulated graphical representationof a dental structure of the patient, the dental structure comprising atleast a portion of the patient's jawbone; creating an actual physicalmodel using computer information corresponding to the simulatedgraphical representation and the data indicative of the desired virtualfixture locations, the actual physical model comprising physicalrepresentations of the at least a portion of the patient's jawbone andof the desired virtual fixture locations; and creating an assemblytemplate comprising one or more guide holes that are oriented based onthe desired virtual fixture locations, the assembly template configuredto be applied to the patient and to guide a drilling tool through theguide holes for drilling one or more holes in the patient's jawboneindicative of the desired virtual fixture locations, wherein aprosthetic installation can be constructed at least in part using theactual physical model, the prosthetic installation configured to attachto the jawbone of the patient via one or more fixtures, and wherein theone or more fixtures are configured to be inserted in the one or moreholes drilled in the patient's jawbone and the prosthetic installationis configured to be installed using the assembly template and the one ormore fixtures.
 29. The method of claim 28, wherein creating the actualphysical model comprises forming one or more holes in the actualphysical model corresponding to the physical representations of thedesired virtual fixture locations.
 30. The method of claim 28, whereinthe creating the assembly template comprises forming the one or moreguide holes.
 31. The method of claim 29, further comprising: applyingthe assembly template to the patient's jawbone; and inserting a drillingtool into the one or more guide holes of the assembly template to formthe one or more holes in the patient's jawbone corresponding to thedesired virtual fixture locations.
 32. The method of claim 28, whereincreating the assembly template comprises producing the assembly templateat least in part using the actual physical model.